Four organizations representing the anesthesia community have jointly sent a letter to the Joint Commission voicing concerns about persisting medication management problems.

The organizations believe several Joint Commission medication management requirements are unnecessary in the anesthesia field and do not contribute to greater safety. For instance, the commission requires two-person verification of medication labels if one person prepares anesthesia and the other person administers, which is a common practice. "Because the contents of the syringe cannot be verified except by reading its label, this requirement, as written, has no added value for patient safety," according to the letter.

Among other issues, the organization also asks for an exemption from a Joint Commission requirement that patients or family be informed about any potential significant adverse drug reactions regarding administration of a new medication. "This standard appears to be directed at medications ordered to treat conditions (e.g., new onset hypertension) and is not practical as applied to anesthesia professionals," according to the letter. "It is nearly impossible to predict all of the anesthesia medications a patient might need to receive during a procedure. Fully explaining the potential adverse effects of dozens of medications to patients and their family members increases anxiety levels for all and adds little value to the patient experience."

Organizations signing the letter were the American Society of Anesthesiologists, American Association of Nurse Anesthetists, American Academy of Anesthesiologist Assistants and the Anesthesia Patient Safety Foundation. The letter is available here.

--Joseph Goedert


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